Hair epilation versus surgical excision as primary management of pilonidal disease in the pediatric population

Pilonidal disease is a chronic, acquired inflammatory process of the skin due to entrapped hair at the natal cleft. Reported recurrence rates are as high as 30%, and recurrence has been attributed to persistent hair near the surgical site. Although conservative measures, such as meticulous hair control and improved perineal hygiene, have been shown to be effective, these techniques typically require much effort on behalf of the patient. Laser hair epilation (LE) might solve this issue of poor patient compliance while helping patients to avoid surgical excision. In this article, we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision in relation to findings from our institution between 2005 and 2013 as well as patient satisfaction with the treatment method

Neutropenia at the Time of Subcutaneous Port Insertion May Not be a Risk Factor for Early Infectious Complications in Pediatric Oncology Patients.

The risk of infection associated with subcutaneous port (SQP) placement in patients with neutropenia remains unclear. We reviewed the rate of early infectious complications (\u3c30 days) following SQP placement in pediatric oncology pateints with /without neutropenia (absolute neutrophil count (ANC) \u3c500/mm3.Baseline characteristics and infectious complications were compared between groups using univariable and multivariable analysis.A total of 614 SQP were placed in 542 patients. Compared to non-neutropenic patients, those with neutropenia were more likely to have leukemia (94% vs 50%), pre-operative fever (22% vs 5%), pre-operative infection (19% vs 9%), and were younger (81 vs 109 months) (p values \u3c0.01).After adjusting for fever and underlying-disease there was a non-significant association between neutropenia and early post operative infection (OR 2.41, 95% CI 0.82-7.18, p=0.116). Only pre-operative fever was a predictor of infection (OR 6.09, 95% CI 2.08-17.81, p=0.564).Neutropenia may not be a predictor of early postoperative infection following SQP placement

Hair epilation versus surgical excision as primary management of pilonidal disease in the pediatric population

Pilonidal disease is a chronic, acquired inflammatory process of the skin due to entrapped hair at the natal cleft. Reported recurrence rates are as high as 30%, and recurrence has been attributed to persistent hair near the surgical site. Although conservative measures, such as meticulous hair control and improved perineal hygiene, have been shown to be effective, these techniques typically require much effort on behalf of the patient. Laser hair epilation (LE) might solve this issue of poor patient compliance while helping patients to avoid surgical excision. In this article, we discuss recurrence rates of pilonidal disease in children treated with LE versus surgical excision in relation to findings from our institution between 2005 and 2013 as well as patient satisfaction with the treatment method

Pre-operative mechanical bowel preparation and prophylactic oral antibiotics for pediatric patients undergoing elective colorectal surgery: a protocol for a randomized controlled feasibility trial

Abstract Background Infections after elective colorectal surgery remain a significant burden for patients and the healthcare system. Adult studies suggest that the combination of oral antibiotics and mechanical bowel preparation is effective at reducing infections after colorectal surgery. In children, there is limited evidence for either of these practices and the utility of combining oral antibiotics with mechanical bowel preparation remains uncertain. Methods This study aims to determine the feasibility of conducting a randomized controlled trial assessing the efficacy of oral antibiotics, with or without mechanical bowel preparation, in reducing the rates of post-operative infection in pediatric colorectal surgery. Participants aged 3 months to 18 years undergoing elective colorectal surgery will be randomized pre-operatively to one of three trial arms: (1) oral antibiotics; (2) oral antibiotics and mechanical bowel preparation; or (3) standard care. Twelve patients will be included in each trial arm. Feasibility outcomes of interest include the rate of participant recruitment, post-randomization exclusions, protocol deviations, adverse events, and missed follow-up appointments. Secondary outcomes include the rate of post-operative surgical site infections, length of hospital stay, time to full enteral feeds, reoperation, readmission, and complications. Discussion If the results of this trial prove feasible, a multi-center trial will be completed with sufficient power to evaluate the optimal pre-operative bowel preperation for pediatric patients undergoing elective colorectal surgery. Trial registration ClinicalTrials.gov: NCT03593252